Out-of-County
Day Treatment
Reauthorization Procedure
STEP 2:
CQRT reauthorization documents must be
to the QA office no more than two
weeks before the end of the
authorization cycle (90 or 180 days) and
before the 4th Thursday of the month (the
CQRT meeting date) in which it
is due. Delayed submissions may result in
services being unauthorized.
STEP 3:
The “CQRT Authorization Form” will be
faxed to the provider from the CQRT
within 24 hours of the CQRT meeting
date. The original CQRT Authorization
Form will be maintained in the QA Office
along with the duplicate medical
record.
Submit the required documentation by mail
to the Quality Assurance Office
with the name, phone and fax number of
the provider’s QA contact.
(Submission of materials must comply with
Federal PHI Privacy practices.)
Quality Assurance Office / CQRT
C/O Nina Berg
Alameda County Behavioral Health Care Services
2000 Embarcadero Cove, Suite 400
Oakland, CA 94112
Additional information and/or forms may
be acquired through the Quality
Assurance Office at 510-567-8105.